ER hoppers

Lately there has been an explosion of ER hoppers in our ER. What are ER hoppers? They are those patients who yesterday, two days ago or whatever went to another ER but felt the need to come to our ER this time. They have various reasons for doing such an idiotic thing. The seven deadly sins. Among them:

1) I didn't get any pain meds for my neck injury from an MVA 2 weeks ago at the other hospital and I'm hoping you will be nicer.
2) I had surgery last week at another hospital, now I am having problems, and your hospital is closer.
3) I didn't like the way they treated me at XYZ hospital.
4) The wait was way too long at the other place
5) I want a second opinion.
6) They didn't do anything for me over there.
7) Family is not happy with care of other doctor, hospital, etc.

ER hoppers are sometimes dumb enough to tell us they were at another hospital. Then there are those who don't. They think we won't find out. But BEWARE, these days we can see if you have been to another hospital in our system. We are also connected to other hospitals as part of a network that shares info, with your kind permission of course.

When I ask people why they didn't go back to the hospital that treated them before, did surgery on them, they are often offended, like I shouldn't ask that. It should be okay to come to a hospital that has no records of your surgery, history, etc. Sorry if I think thats stupid.

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Martha Stewarts fat lip - its not a good thing

Poor Martha Stewart. Her dog jumped up and gave her a fat lip and a cut. What did Martha do? She called the police to give her a ride to the hospital. Apparently she couldn't drive herself or get someone to drive her. You know, I don't think the police would drive me to the hospital if I called them.

Another call Martha made was to someone else so they could have a plastic surgeon come to repair her laceration. I'm sure Martha went straight back, was seen right away....do not pass go, do not collect $200. I don't think I would have got back that fast and an ordinary ER doc would have stitched me up.

This is the kind of stuff that drives ER nurses nuts. Some people are given VIP treatment. We will get a call periodically about so and so is coming in and they just want to LET US KNOW. Or someone will call one of our docs and tell them some "VIP" is coming and we are supposed to take them DIRECTLY BACK TO A ROOM.

Our thought: Every body should be treated the same. We don't like treating certain people special. ER is one of those places where everybody should be equal.

20 lashes with a tourniquet

What is a nurses priority in a hospital? Giving great patient care right? Wrong. To me, these days, it feels like documentation is the most important part of my job. The emphasis now in the hospital is have you filled in all the blanks on the computer that you need to in order to be compliant with JCAHO, Medicare, etc. Have you documented location, quality, aggravating factors, level of pain? After giving pain meds did you revital and redo level of pain 30 minutes after? Did you do discharged/admission vital signs? Did you reconcile all meds and record last time the med was taken? Did you fill in all of the many blanks around conscious sedation? Did you do the proper trauma charting so that statistics can be gathered? Screen for MRSA, VRE, TB. Did you screen the patient for potential abuse, suicidal thoughts? And these are just a few.

I spend the majority of my time doing documentation these days, crossing t's, dotting i's, filling in the myriad of blanks that need to be filled in. My documentation is tracked and if I don't do it right, I am given a note. A naughty nurse note. If it happens again I am placed in the staff time out chair in the middle of the ER. A third time? 20 lashes with a tourniquet.

o if you wonder why the nurse doesn't come in your room that often it is because she is out there documenting all the things that are required.

home james!

I wonder if other states have this service: cab rides for those on medical assistance. Everyday in our ER there is literally a line up of people under age 30 calling to get a cab ride home from the hospital. Now mind you these are not disabled people. These are able bodied young adults who are eligible for MA.

They get on the phone and wait for 15 or 20 minutes for someone to come on the line. Usually we have to verify that they were really there. Then they sit there and wait for the cab. I am amazed at the time people will spend setting this up. They could have walked home before it was all complete.

If you are a working person who makes too much for medical assistance, sorry you are going to have to take a bus, get a ride or walk. You are chopped liver. I was telling a co worker that we should open a medical limousine service for those on medical assistance. All we would do is transport those on medicaid around in style. No doubt we could get a big fat contract with the state..

Perhaps the government could stop this kind of stuff to reduce the deficit. What a country.